As Congress Returns, Ryan White Reauthorization Gets a Hearing

As one reminder that Congress really is coming back into session next week, the House Energy and Commerce Subcommittee on Health announced that it will hold a hearing next Wednesday, September 7, at 11am on the Ryan White Reauthorization discussion draft legislation.

As many readers are likely aware, at the end of September, the Ryan White program’s authorization will not only expire, but its authority will be repealed. Ryan White is, of course, the federal government’s largest stream of discretionary funding dedicated to the treatment of HIV/AIDS. Unlike when a program’s authorization expires and the program’s activities can continue as long as funds are available, a repeal actually hinders the federal agency’s ability to administer the program. In the case of Ryan White, the agency in question is the Health Resources and Services Administration (HRSA). As a result, the looming repeal generated a good deal of consternation among grantees in the field, and a fair amount of discussion at NACHC’s Community Health Institute and Expo (CHI).

Some months ago, NACHC joined numerous stakeholder groups from around the country in supporting the “community consensus” document on Ryan White. The document calls for a three year reauthorization of the Ryan White program, and makes a number of other recommendations. That consensus document reportedly served as a starting point for the congressional committees of jurisdiction- the House Energy and Commerce and Senate HELP Committees- to begin to assemble a reauthorization bill.

NACHC also heard from grantees at CHI about an issue of particular concern to Part C’s (the Ryan White category that most health center grantees fall into). A number of Part C grantees have budget years that end Dec. 31, and they would be the first Ryan White grantees to face the impact of the repeal. NACHC has communicated this concern to the House Energy and Commerce Committee, and they were not only aware of the issue, but they are working with the Obama Administration to ensure that there are no progam disruptions.

Next Wednesday, the House Energy and Commerce Subcommitee on Health will hold its first hearing on a discussion draft of the reauthorization legislation. HRSA Administrator Mary Wakefield is reportedly scheduled to testify, with additional witnesses yet to be announced.

Stay tuned to Health Centers on the Hill for future updates on Ryan White. In the weeks to come, we can expect a good deal of activity on this issue, as Congress is likely to consider both a stand-alone reauthorization as well as some sort of temporary “fix” to ensure that all Ryan White activities continue uninterrupted.

Under a national program that includes all uninsured and rules out all pre-exisitng conditions; how will this and other disease specific or “special population” programs continue? Do national health reforms preserve special population programs or will the clients become part of the new insurance exchanges?

Hi M. Rodolico- While there has been a fair amount of behing the scenes conversation on this very topic as health reform is being considered. there are few actual instances in any of the health reform bills where a “special population” program is eliminated under the new system. Indeed, the Ryan White Reauthorization, as one example, has been considered by members of both parties to be complimentary to reform and is being considered in parallel to the health overhaul. One notable exception to this is the CHIP program, which is envisioned as ultimately becoming part of the “exchange.” This change has generated some controversy, and it is still being debated.

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